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Biomedical subjects

K Azuma

Publications and source records attributed to K Azuma.

173 records · Page 10Linked to original sources
PubMedDate not supplied

IgD multiple myeloma with renal involvement: case report.

IgD multiple myeloma is a unique type of multiple myeloma which is characterized by increased serum IgD and IgD type M-component in immunoelectrophoresis. It frequently shows renal involvement but it is a rare form of myeloma. The distinctive features of IgD myeloma are the dominance in males, high frequency in younger persons, and the uncertain appearance of M-component in serum electrophoresis. We experienced 3 cases of IgD multiple myeloma with renal failure which required hemodialysis before IgD myeloma was diagnosed. It is important to consider IgD myeloma when treating the patients with renal involvement of unknown origin.

Acute Kidney Injury↗
PubMedDate not supplied

Adjuvant hepatic arterial infusion chemotherapy after radical hepatectomy for hepatocellular carcinoma--results of long-term follow-up.

BACKGROUND/AIMS: This clinical study aimed to clarify the effectiveness and indication of adjuvant hepatic arterial infusion chemotherapy (HAIC) that is performed to prevent recurrence after radical hepatectomy for hepatocellular carcinoma (HCC). METHODOLOGY: From January 1986 to December 1992, 135 HCC patients, who tolerated curative hepatic resection in which all of the macroscopic HCC was removed, were included in this study. They were divided into two groups. One group was comprised of 68 patients who received HAIC after radical hepatectomy (HAIC (+) group), and the other group was comprised of 67 patients who received radical hepatectomy alone (HAIC (-) group). In the HAIC (+) group, an emulsion of doxorubicin (30-50 mg) and lipiodol (3-5 ml) was injected from a reservoir every 2 or 3 months for 1 year. RESULTS: The cumulative survival rates in the HAIC (+) group (79.1%, 54.5% and 39.9% at 3, 5, and 7 years after hepatectomy, respectively) were better than those in the HAIC (-) group (69.2%, 38.1% and 26.8%, respectively) (p = 0.086). The disease-free survival rates in the HAIC (+) group (50.8%, 31.7% and 25.6% at 3, 5, and 7 years after hepatectomy, respectively) were significantly better than those in the HAIC (-) group (25.7%, 20.6% and 6.4%, respectively) (p = 0.006). This improvement was evident for 3 years after hepatectomy. The adjuvant HAIC was effective especially in patients with good liver function, whose tumor size ranged between 2.1 cm and 5 cm in diameter, and who received a minor hepatic resection. CONCLUSIONS: Adjuvant HAIC was effective in preventing recurrence after radical hepatectomy for HCC. This treatment is especially indicated for patients with good liver function, whose tumor size ranges between 2.1 cm and 5 cm in diameter, and who have received a minor hepatic resection.

Adult↗
PubMedDate not supplied

Ruptured duodenal varices: an autopsy case report.

Bleeding from duodenal varices is a rare and life-threatening complication of cirrhosis. The diagnosis and management of this disease remains problematic. We herein report an autopsy case of a patient who suffered from recurrent bleeding from duodenal varices. A 48 year-old man with cirrhosis presented with upper gastrointestinal bleeding. He had three episodes of massive melena during the 6 months prior to admission. However, the source of bleeding was not known. Emergent endoscopy revealed jet bleeding from varices in the second to third portion of the duodenum. Endoscopic ethanol injection sclerotherapy was attempted but rebleeding occurred and the patient died.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Hepatic resection with tumor thrombectomy for hepatocellular carcinoma with tumor thrombi in the major vasculatures.

BACKGROUND/AIMS: It is still controversial whether surgical or non-surgical treatments should be adopted for hepatocellular carcinomas (HCC) with tumor thrombi (TT) in the major vasculatures. We evaluate the effectiveness of and the indications for hepatic resection with tumor thrombectomy for such patients. METHODOLOGY: Seventeen patients with TT in the major vasculatures caused by HCC were enrolled. Eleven patients had Vp3 TT, 5 patients had Vv3 TT, and 1 patient had Vp3 and Vv3 TT, concurrently. Out of the 17 patients, 13 underwent hepatic resections with tumor thrombectomies and the remaining 4 received only hepatic resections without tumor thrombectomies. RESULTS: In patients with Vp3 TT, median and mean survival times were 7.8 and 18.5 months, respectively, and 1- and 5-year survival rates were 36.4% and 18.2%, respectively. In patients with Vv3 TT, median and mean survival times were 9.9 and 8.4 months, respectively. Patients who underwent hepatic resections with tumor thrombectomies had significantly better prognoses than those who did not receive tumor thrombectomies (p=0.0039). CONCLUSIONS: The prognosis of HCC patients with TT in the major vasculatures, who have relatively small primary tumors, good hepatic functional reserves and no distant metastases should be good, if hepatic resections with tumor thrombectomies are performed.

Adult↗
PubMedDate not supplied

Autoimmune cholangiopathy associated with rheumatoid arthritis.

We herein describe a patient with autoimmune cholangiopathy complicated with rheumatoid arthritis. A 58-year-old female was admitted to our hospital due to complications of arthralgia in her fingers, shoulders, elbows, knees and ankles. She presented with abnormally elevated levels of transaminases, alkaline phosphatase and was also negative for hepatitis B virus, hepatitis C virus and the serum mitochondrial antibody test, but had high titers of serum antinuclear antibody, rheumatoid factor and rheumatoid arthritis hemagglutination. A liver biopsy specimen showed chronic non-suppurative destructive cholangitis. She was thus diagnosed to have autoimmune cholangiopathy and rheumatoid arthritis. She began treatment with prednisolone 40 mg per day. After 20 days of steroid therapy, her hepatic function tests improved and the arthralgia symptoms disappeared. This is, to our knowledge, the first case of autoimmune cholangiopathy associated with rheumatoid arthritis, in which both symptoms improved with steroid therapy.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Roentgenologic-pathologic correlations of miliary pulmonary metastases.

To determine the accurate localization of nodules of miliary pulmonary metastases within the secondary lobules, a Roentgenologic-pathologic study was made, using an inflated and fixed lung that was excised at autopsy from a patient who died of small cell carcinoma of the left lower lobe. Nodules in the perilobular area and nonperilobular areas were counted using 1-mm-thick specimens and their radiographs. It was found that 78% of the metastatic nodules were located in the perilobular area and 22% in the nonperilobular area. Furthermore, 13% of the metastatic nodules in the perilobular area showed tumor thrombosis in the lymphatic vessels, while none of the metastases in the perilobular area showed any tumor thrombosis. These results suggest that miliary pulmonary metastases are predominantly distributed in the perilobular area and that this finding is helpful in the diagnosis of this disease when high resolution computed tomography is used.

Adult↗
PubMedDate not supplied

Pulmonary lymphangiomyomatosis.

Two cases of pulmonary lymphangiomyomatosis are reported and findings of high resolution computed tomography (CT) are described. CT reveals that most lesions appearing reticular or emphysematous on radiographs are actually cysts, and accurately displays the extent and distribution of cystic change of the lung. On high resolution CT, individual cystic walls are much better displayed than on routine 10 mm section CT. Further, it is possible to detect even trivial pleural effusion and mediastinal lymph node swelling by CT.

Adult↗
PubMedDate not supplied

Electron-beam CT angiography for thoracic aortic aneurysm and dissection: application of continuous volume scan and electrocardiographically triggered scan.

PURPOSE: To assess the diagnostic value of CT angiography of thoracic aortic aneurysm and dissection with electron-beam CT. MATERIALS AND METHODS: Electron-beam CT angiography was used for the evaluation of thoracic aortic aneurysm (n = 15), and aortic dissection (n = 15). Continuous volume scan (CVS), permitted by continuous X-ray exposure with table incrementation, was performed in all patients. An additional electrocardiographically triggered scan was obtained in four patients. Three-dimensional surface display and multiplanar reformations were obtained and compared with digital subtraction angiography. RESULTS: Motion artifacts and the resulting degradation of three-dimensional image quality were frequent in the ascending aorta of CVS images. Electrocardiographically triggered sections improved the image quality of the ascending aorta. In the aortic arch and descending aorta, excellent three-dimensional images competitive in quality with digital subtraction angiography were obtained in all patients. For patients with aortic dissection, multiplanar reformation was useful to demonstrate the intimal flap and entry sites. CONCLUSION: The use of electron-beam CT angiography is feasible for the diagnosis of thoracic aortic aneurysm and dissection.

Aged↗
PubMedDate not supplied

Impaired in vivo tumor growth of human pancreatic carcinoma cells retrovirally transduced with GM-CSF gene.

We have examined the antitumor effect of human pancreatic carcinoma cells (AsPC-1) retrovirally transduced with mouse granulocyte macrophage-colony stimulating factor (GM-CSF) gene in nude mice. Growth retardation of the subcutaneous tumors of GM-CSF-producing AsPC-1 cells was observed, although their in vitro proliferation was not different from that of wild-type cells. Histological examination revealed infiltration of monocytic cells into the tumor of GM-CSF-producing cells, and they were shown to be mainly CD11b positive cells by immunohistochemical staining. The survival of the mice inoculated intraperitoneally with GM-CSF- producing AsPC-1 cells was significantly prolonged compared with that of the mice inoculated with wild-type AsPC-1 cells. Thus, the expression of GM-CSF gene in human pancreatic cells induced an antitumor effect in vivo even in the mature T cell-deficient condition.

Animals↗
PubMedDate not supplied

Studies of postoperative transarterial infusion chemotherapy for liver metastasis of colorectal carcinoma after hepatectomy.

BACKGROUND/AIMS: The aim of this study was to evaluate the efficacy of postoperative transarterial infusion chemotherapy (PTIC) for the prevention of metastatic liver cancer recurrence after hepatectomy following curative surgery for colorectal carcinoma. METHODOLOGY: Thirty-eight patients who underwent curative hepatectomy for metastatic liver cancer from colorectal carcinoma were studied. Ten out of the 38 patients received PTIC (experimental group) and 28 patients did not receive chemotherapy (control group). PTIC was performed with an intrahepatic indwelling catheter, which was set-up for 3 weeks and repeated 3 times in two monthly intervals. RESULTS: In the control group, no significant differences were observed in the survival between patients with a single hepatic nodule and those with multiple hepatic nodules. Between patients with hepatic tumors of more than 3 cm in diameter and those with tumors less than 3 cm, and between patients with tumors located at H1 and H2, no significant differences were seen, either. However, the 5-year survival rate of the patients with metachronous liver metastases was 90% which was significantly better than for those patients with synchronous liver tumors (p < 0.05). The 100% of 3- and 100% of 4-year survival rates of the experimental group were significantly better than the 60% and 47% respectively of the control group (p < 0.05). The non-recurrence rate in the remnant liver was also significantly better in the experimental group than that in the control group (p < 0.01). The adverse effect of this protocol was negligible. CONCLUSION: We conclude that PTIC improved the survival and non-recurrence rate in the remnant liver of the patients with liver metastases from colorectal cancer after hepatectomy, and was considered to be safe and an important protective factor for the prevention of recurrence of liver metastases after hepatectomy.

Adult↗